Sleep Under Housing Insecurity In School-Aged Children and Adolescents: A Scoping Review of Pathways and Mechanisms

Introduction and Purpose:

Sleep problems affect more than 30% of school-aged children and adolescents, serving as a critical determinant of academic performance and cognitive and emotional well-being. While sleep is a biological necessity, it is profoundly shaped by socio-environmental conditions; children facing poverty and material constraints are at a disproportionate risk for chronic sleep deprivation. Housing, in particular, functions as a primary structural foundation that organizes daily circadian rhythms and ensures physiological stability. Despite its importance to sleep, housing insecurity is often conflated with general poverty, and little is known about the systematic understanding of the pathways through which housing insecurity disrupts developmental sleep processes. To address these gaps, we map how the relationship between housing insecurity and sleep has been conceptualized and measured, identifying key pathways and directions for future social work research and policy.

Methods:

Applying PRISMA guidelines and the Arksey and O’Malley framework, we conducted a scoping review to map research on housing insecurity and sleep, focusing on empirical studies. We consulted with academic librarians to refine search terms and validate the selection of databases (i.e., Science, PubMed, Scopus, and Social Services Abstracts). A total of 628 records were identified, and 333 remained after deduplication. To ensure systemic rigor, two reviewers independently conducted title and abstract screening followed by full-text review using Rayyan software. Finally, 7 studies were included for data extraction and thematic synthesis.

Results:

Housing insecurity was partially distinguished into spatial indicators (e.g., overcrowding; n=2) and temporal exposures (e.g., eviction; n=1), but many studies (n=4) did not treat these independently, instead embedding housing within broader structural inequality or material deprivation. Sleep was primarily measured using single indicators (e.g., duration; n=3), with few multidimensional approaches (n=2). Nevertheless, housing insecurity was consistently associated with shorter sleep, greater disturbance, and lower regularity, with micro-environmental factors such as perceived safety sometimes more predictive than housing type. Mechanism analysis was limited: mediation was tested in only one study (maternal mental health), while most studies suggested only stress or rhythm-disruption pathways. Housing was often treated as part of broader social risk exposure, and studies isolating its unique pathways were rare.

Conclusions:

Housing–sleep research in children and adolescents remains conceptually and analytically fragmented. Housing insecurity is often reduced to a single risk factor or embedded within broader social risks, obscuring its distinct pathways. Simultaneously, sleep is frequently reduced to a single indicator, limiting its interpretation as a developmental and structural outcome. Given that housing is a structural condition that shapes children’s developmental environment, the housing–sleep relationship warrants a more fundamental reconsideration. Future research should conceptualize housing insecurity across temporal and spatial dimensions and recognize sleep as a structural indicator of equity. This shift is essential for designing multi-layered social policies that move beyond general poverty relief to address the specific housing-based mechanisms that compromise children’s physiological well-being.